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Spotlight on morning-after pill for women

Mumbai, Aug. 28: This pill could change the lives of many women — and men. But it still hasn’t.

The “after” pill, which a woman can have to prevent pregnancy after unprotected sex or contraceptive failure, has been in the Indian market for about two years, but is yet to be noticed.

Now, the National Institute for Research in Reproductive Health, Mumbai, which is part of the government-funded Indian Council of Medical Research, has launched a programme to create more awareness about it.

Called the emergency contraceptive pill, it can stop pregnancy by temporarily preventing the release of an egg from a woman’s ovary or can stop fertilisation. It is a concentrated form of the common hormone-based oral pill for women.

The emergency pill — of which several brands are available in the market — is a “safe” two-tablet dosage: one tablet is to be had within 72 hours of the intercourse, followed by another within 12 hours. The first tablet is best had within 24 hours of the sexual act. In cases where the pill was had within 24 hours, the contraception proved 85 per cent effective.

So, no more running to the chemists for a pregnancy kit or rushing to the doctor fearing the worst. But why is it not that way'

Dr C.P. Puri, director, National Institute for Research in Reproductive Health, which held a three-day seminar on emergency contraception that ended today, has some answers. First, he points out how the pill can help.

“There are about seven million abortions induced annually in India of which an overwhelming majority is done in a clandestine way,” said Puri, adding that recent surveys show that almost 78 per cent of conceptions in the country are “unplanned” and 25 per cent “unwanted”.

“But because there has been no effort to educate people on the matter, hardly anyone knows about it,” he says. “So the institute has come up with a number of ideas — like a series of posters — to explain and popularise the concept all over the country, reaching out to rural areas.”

The institute will approach the Centre to step up the campaign for emergency contraceptive once the literature and other materials are ready. There is also a proposal to evolve an easy Hindi word for emergency contraception, so long referred to only in English.

“The pill, which is also quite cheap, at around Rs 50, should catch on now,” says Puri, before going on to elaborate its problems. Though very effective, it’s not exactly a wonder drug, and it comes with baggage, both physiological and moral.

“It’s not easy to advertise in print or on TV such a pill, which comes with very specific instructions and dosage and has several side effects,” says eminent gynaecologist Indira Hinduja. The side effects include nausea, vomiting and change in menstrual cycle.

“That’s why our institute is devising materials to educate the people,” adds Puri.

But the pill — the most contemporary form of emergency contraception — is also the symbol of social change, other doctors feel.

“We have always been practising emergency contraception by increasing the dosage of the oral pill,” says gynaecologist A. Malpani. “The pill per se is only a repackaging of that,” he adds.

“Emergency contraception was not always encouraged by the doctors themselves because of the perceived sexual irresponsibility it carried, especially on the part of women. Many thought that if women knew there was a way out, they would think less about indulging in sexual acts,” says Malpani.

“Now we think differently. Women are seen as being responsible for their own bodies. Possibly the pill manufacturers will step up the campaign themselves in the changed climate,” he adds.

But the pill still comes with a lot of caution. “The operative word is emergency and it is no substitute for regular contraception. It is to be indulged in only if contraception fails,” says Puri.

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